Individual provider Active NPI

Shane William Hartie, MDIV

  • Counselor
  • Haverford, PA
National Provider Identifier
1861894693
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
551 W Lancaster Ave
Haverford, PA 19041-1419
Phone
(610) 526-1974
NPI assigned
Sep 24, 2014
Last updated
Sep 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PA Primary

Addresses

Primary practice location

551 W Lancaster Ave
Haverford, PA 19041-1419

Mailing address

4336 Teesdale St
Philadelphia, PA 19136-3903
Phone (904) 302-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1861894693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4336 TEESDALE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191363903",
            "telephone_number": "904-302-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 W LANCASTER AVE",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411419",
            "telephone_number": "610-526-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTIE",
        "first_name": "SHANE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MDIV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.